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  2. CQM-697

CMS31v2/NQF1354 Possible hole in denominator exclusion

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    • Tamara Bailey
    • 520.750.4324
    • Midas+
    • Thank your for your questions. Although the example is very rare, the suggestion of binding left and right LOINC codes is valid. This update was completed during the April 2014 measure annual update.

      The denominator exclusion logic exists as follows:

      AND NOT:
      OR: "Diagnostic Study, Result: Hearing Examination"
      OR: "Diagnostic Study, Result: Newborn Hearing Screen Left"
      OR: "Diagnostic Study, Result: Newborn Hearing Screen Right"
      during "Occurrence A of Encounter, Performed: Inpatient Encounter"
      AND: "Patient Characteristic Expired: Patient Expired" during "Occurrence A of Encounter, Performed: Inpatient Encounter"

      If a patient has: "Diagnostic Study, Result: Newborn Hearing Screen Left" but dies before "Diagnostic Study, Result: Newborn Hearing Screen Right" is completed, shouldn't they be excluded from the denominator? As the logic stands, this patient would be in the Denominator.

      suggest possible logic change to:
      AND NOT:
      OR: "Diagnostic Study, Result: Hearing Examination"
      OR:
      AND: "Diagnostic Study, Result: Newborn Hearing Screen Left"
      AND: "Diagnostic Study, Result: Newborn Hearing Screen Right"
      during "Occurrence A of Encounter, Performed: Inpatient Encounter"
      AND: "Patient Characteristic Expired: Patient Expired" during "Occurrence A of Encounter, Performed: Inpatient Encounter"

      To avoid this possible hole.

            abt.associate Abt Associate (Inactive)
            tamarabailey Tamara Bailey (Inactive)
            Deborah Krauss (Inactive), Saul Kravitz (Inactive)
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              Created:
              Updated:
              Resolved: